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Liao XS, Jin HY, Zhu LP, Luo WJ, Wang Y, Hu SQ. Application of Femtosecond Laser + Piggyback Multifocal Intraocular Lens Implantation in Patients with Super-High Myopia Complicated with Cataract. Semin Ophthalmol 2024; 39:217-222. [PMID: 37997000 DOI: 10.1080/08820538.2023.2275618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/19/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To observe the clinical effect of piggyback multifocal intraocular lens (IOL) implantation in treating patients with high myopia complicated with cataract. METHODS This was a prospective controlled study. We compared 32 eyes of 32 patients who underwent femtosecond laser-assisted cataract surgery with piggyback IOL implantation (two IOLs were implanted into the capsule) with 32 eyes of 32 patients who also underwent the same surgery (one IOL implanted into the capsule) due to high myopia complicated with cataract at the Wuhan Aier Eye Expert Hospital between January 2019 and October 2020. All patients were followed up for three months after surgery. Uncorrected distance visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), best-corrected distance visual acuity, distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), postoperative spectacle independence, postoperative visual interference, equivalent spherical lens, defocus curve, and IOL tilt and eccentricity were evaluated. RESULTS Three months after surgery, the patients' UCIVA, UCNVA, DCIVA, and DCNVA were 0.49 ± 0.07, 0.38 ± 0.15, 0.47 ± 0.09, and 0.36 ± 0.12, respectively, in the research group and 0.56 ± 0.18, 0.72 ± 0.22, 0.55 ± 0.13, and 0.69 ± 0.15, respectively, in the control group; the differences between the two groups were statistically significant (P < .05). The spectacle independence rate was higher in the research group (93%) than in the control group (13%). The overall satisfaction regarding postoperative visual quality was also higher in the research group than in the control group. The absolute mean value of the spherical equivalents was 0.48 ± 0.28 D in the research group and 0.62 ± 0.33 D in the control group; the difference between the two groups was statistically significant (P < .05). CONCLUSION Piggyback multifocal IOL implantation can expand the multifocal IOL application range, and satisfy the desire of patients with high myopia complicated with cataract to see both near and far.
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Affiliation(s)
- Xian-Shan Liao
- Health Science Center, Yangtze University, Jingzhou, China
| | - Hui-Yu Jin
- Department of Ophthalmology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li-Ping Zhu
- Department of Orthopedics, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Wen-Jing Luo
- Department of Cataract, Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Yong Wang
- Department of Cataract, Aier Eye Hospital of Wuhan University, Wuhan, China
| | - Shu-Qiong Hu
- Department of Cataract, Aier Eye Hospital of Wuhan University, Wuhan, China
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Li S, Li X, Liang W, Wu Z, Jia Y, Ma Y, Chu L, Jin T, Li L, Li Q, Qin M. Improving the accuracy of the SRK/T formula in Chinese with implanting less than 10 D IOL calculated by the SRK/T formula: the SRK/T-Li formula. Int Ophthalmol 2024; 44:32. [PMID: 38329567 DOI: 10.1007/s10792-024-03040-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE To explore the accuracy of the improved SRK/T-Li formula in eyes following implantation of intraocular lens (IOL) of less than 10 D as calculated by using the SRK/T formula in Chinese. METHODS A total of 489 eyes from 489 patients with cataracts were included in this study. These patients were divided into a training set (271 patients) and a testing set (218 patients). The IOL power calculated by using SRK/T was less than 10 D. We evaluated the accuracy of the modified SRK/T-Li formula (P = PSRK/T × 0.8 + 2 (P = implanted IOL power; PSRK/T = IOL power calculated by SRK/T)). We evaluated the mean absolute error (MAE), percentage of prediction error (PE) within ± 0.25, ± 0.50, and ± 1.00 D, and the percentage of postoperative hyperopia. RESULTS The MAE values in order of lowest to highest were as follows: 0.412 D (SRK/T-Li), 0.414 D (Barrett Universal II, (BUII)), 0.814 D (SRK/T), and 1.039 D (Holladay 1). The percentage of PE within ± 0.25 D, ± 0.50 D, and ± 1.00 D was 38.99%, 69.27% and 92.66% (BUII), 40.83%, 69.27% and 94.04% (SRK/T-Li), 20.64%, 41.28% and 71.56% (SRK/T), and 7.34%, 16.51% and 53.21% (Holladay 1), respectively. SRK/T-Li had the smallest postoperative hyperopic shift. CONCLUSIONS For Chinese patients with an IOL power of less than 10 D as calculated by using the SRK/T, the SRK/T-Li has good accuracy and is the best choice to reduce postoperative hyperopic shift.
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Affiliation(s)
- Shaowei Li
- Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha, 410083, Hunan, China.
- Department of Ophthalmology, Beijing Aier-Intech Eye Hospital, Number 12 of Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
| | - Xinxin Li
- Department of Ophthalmology, Aier School of Ophthalmology, Central South University, Changsha, 410083, Hunan, China
| | - Weiyan Liang
- Department of Ophthalmology, Beijing Aier-Intech Eye Hospital, Number 12 of Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Zheming Wu
- Department of Ophthalmology, Guangzhou Aier Eye Hospital, Guangzhou, 510080, Guangdong, China
| | - Yanhong Jia
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Yanran Ma
- Department of Ophthalmology, Chongqing Aier Eye Hospital, Chongqing, 400000, China
| | - Ling Chu
- Department of Ophthalmology, Shenyang Aier Eye Hospital, Shenyang, 110003, Liaoning, China
| | - Tianru Jin
- Department of Ophthalmology, Shenyang Aier Eye Hospital, Shenyang, 110003, Liaoning, China
| | - Li Li
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Qiumei Li
- Department of Ophthalmology, Beijing Aier-Intech Eye Hospital, Number 12 of Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Ming Qin
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
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Bansal M, Thakur A, Gupta G, Jurangal A, Khanna R, Malhotra C, Gupta A, Jain AK. Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in patients with axial hyperopia. Indian J Ophthalmol 2022; 70:4295-4299. [PMID: 36453332 PMCID: PMC9940539 DOI: 10.4103/ijo.ijo_1307_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose This study was conducted to evaluate the accuracy of intraoperative aberrometry (IA) in intraocular lens (IOL) power calculation and compare it with conventional IOL formulas. Methods This was a prospective case series. Eyes with visually significant cataract and axial hyperopia (AL <22.0 mm) underwent IA-assisted phacoemulsification with posterior chamber IOL (Alcon AcrySof IQ). Postoperative spherical equivalent (SE) was compared with predicted SE to calculate the outcomes with different formulas (SRK/T, Hoffer Q, Haigis, Holladay 2, Barrett Universal Ⅱ and Hill-RBF). Accuracy of intraoperative aberrometer was compared with other formulas in terms of mean absolute prediction error (MAE), percentage of patients within 0.5 D and 1 D of their target, and percentage of patients going into hyperopic shift. Results Sixty-five eyes (57 patients) were included. In terms of MAE, both Hoffer Q (MAE = 0.30) and IA (MAE = 0.32) were significantly better than Haigis, SRK/T, and Barrett Universal Ⅱ (P < 0.05). Outcomes within ±0.5 D of the target were maximum with Hoffer Q (80%), superior to IA (Hoffer Q > IA > Holladay 2 > Hill-RBF > Haigis > SRK/T > Barrett Universal Ⅱ). Hoffer Q resulted in minimum hyperopic shift (30.76%) followed by Hill-RBF (38.46%), Holladay 2 (38.46%), Haigis (43.07%), and then IA (46.15%), SRK/T (50.76%) and Barrett Universal Ⅱ (53.84%). Conclusion IA was more effective (statistically significant) in predicting IOL power than Haigis, SRK/T, and Barrett Universal Ⅱ although it was equivalent to Hoffer Q. Hoffer Q was superior to all formulas in terms of percentage of patients within 0.5 D of their target refractions and percentage of patients going into hyperopic shift.
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Affiliation(s)
- Muskaan Bansal
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anchal Thakur
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gaurav Gupta
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Jurangal
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Khanna
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Chintan Malhotra
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Gupta
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arun Kumar Jain
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Correspondence to: Prof. Arun Kumar Jain, Professor of Ophthalmology, Advanced Eye Center, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh – 160 012, India. E-mail:
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Wendelstein J, Kohnen T, Casazza M, Heath M, Riaz KM, Cooke DL, Hoffmann P, Langenbucher A. Update on Biometry and Lens Calculation - A Review of the Basic Principles and New Developments. Klin Monbl Augenheilkd 2022; 239:960-970. [PMID: 35973683 DOI: 10.1055/a-1896-0738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
These days, accurate calculation of artificial lenses is an important aspect of patient management. In addition to the classic theoretical optical formulae there are a number of new approaches, most of which are available as online calculators. This review aims to explain the background of artificial lens calculation and provide an update on study results based on the latest calculation approaches. Today, optical biometry provides the computational basis for theoretical optical formulae, ray tracing, and also empirical approaches using artificial intelligence. Manufacturer information on IOL design and IOL power recorded as part of quality control could improve calculations, especially for higher IOL powers. With modern measurement data, there is further potential for improvement in the determination of the axial length to the retinal pigment epithelium and by adopting a sum-of-segment approach. With the available data, the cornea can be assumed to be a thick lens. The Kane formula, the EVO 2.0 formula, the Castrop formula, the PEARL-DGS, formula and the OKULIX calculation software provide consistently good results for artificial lens calculations. Excellent refractive results can be achieved using these tools, with approximately 80% having an absolute prediction error within 0.50 dpt, at least in highly selected study populations. The Barrett Universal II formula also produces excellent results in the normal and long axial length range. For eyes with short axial lengths, the use of Barrett Universal II should be reconsidered; in this case, one of the methods mentioned above is preferable. Second Eye Refinement can also be considered in this patient population, in conjunction with established classic third generation formulae.
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Affiliation(s)
- Jascha Wendelstein
- IROC, Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Schweiz.,Abteilung für Augenheilkunde und Optometrie, Johannes Kepler Universität Linz, Österreich.,Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Deutschland
| | - Thomas Kohnen
- Klinik für Augenheilkunde, Goethe-Universität, Frankfurt, Deutschland
| | - Marina Casazza
- Abteilung für Augenheilkunde und Optometrie, Johannes Kepler Universität Linz, Österreich
| | - Michael Heath
- College of Medicine, University of Oklahoma, Norman, Oklahoma, United States
| | - Kamran M Riaz
- University of Oklahoma, Dean McGee Eye Institute, Oklahoma City, Oklahoma, United States
| | - David L Cooke
- Great Lakes Eye Care, Saint Joseph, United States.,Department of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan, United States
| | | | - Achim Langenbucher
- Institut für Experimentelle Ophthalmologie, Universität des Saarlandes, Homburg/Saar, Deutschland
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Shrivastava AK, Nayak S, Mahobia A, Anto M, Pandey P. Accuracy of intraocular lens power calculation formulae in short eyes: A systematic review and meta-analysis. Indian J Ophthalmol 2022; 70:740-748. [PMID: 35225507 PMCID: PMC9114558 DOI: 10.4103/ijo.ijo_934_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This review article attempts to evaluate the accuracy of intraocular lens power calculation formulae in short eyes. A thorough literature search of PubMed, Embase, Cochrane Library, Science Direct, Scopus, and Web of Science databases was conducted for articles published over the past 21 years, up to July 2021. The mean absolute error was compared by using weighted mean difference, whereas odds ratio was used for comparing the percentage of eyes with prediction error within ±0.50 diopter (D) and ±1.0 D of target refraction. Statistical heterogeneity among studies was analyzed by using Chi-square test and I2 test. Fifteen studies including 2,395 eyes and 11 formulae (Barrett Universal II, Full Monte method, Haigis, Hill-RBF, Hoffer Q, Holladay 1, Holladay 2, Olsen, Super formula, SRK/T, and T2) were included. Although the mean absolute error (MAE) of Barrett Universal II was found to be the lowest, there was no statistically significant difference in any of the comparisons. The median absolute error (MedAE) of Barrett Universal II was the lowest (0.260). Holladay 1 and Hill-RBF had the highest percentage of eyes within ±0.50 D and ±1.0 D of target refraction, respectively. Yet their comparison with the rest of the formulae did not yield statistically significant results. Thus, to conclude, in the present meta-analysis, although lowest MAE and MedAE were found for Barrett Universal II and the highest percentage of eyes within ±0.50 D and ±1.0 D of target refraction was found for Holladay 1 and Hill-RBF, respectively, none of the formulae was found to be statistically superior over the other in eyes with short axial length.
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Affiliation(s)
- Ankur K Shrivastava
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Swatishree Nayak
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | | | - Mary Anto
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Pranay Pandey
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Shrivastava AK, Nayak S, Mahobia A, Anto M, Kacher R, Kumar A. Optimizing lens constants specifically for short eyes: Is it essential? Indian J Ophthalmol 2021; 69:2293-2297. [PMID: 34427203 PMCID: PMC8544056 DOI: 10.4103/ijo.ijo_63_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose: Optimization of lens constants is a critically important step that improves refractive outcomes significantly. Whether lens constants optimized for the entire range of axial length would perform equally well in short eyes is still a matter of debate. The aim of this study was to analyze whether lens constants need to be optimized specifically for short eyes. Methods: This retrospective observational study was conducted at a tertiary care hospital in Central India. Eighty-six eyes of eighty-six patients were included. Optical biometry with IOLMaster 500 was done in all cases and lens constants were optimized using built-in software. Barrett Universal II, Haigis, Hill-RBF, Hoffer Q, Holladay 1, and SRK/T formulae were compared using optimized constants. Mean absolute error, median absolute error (MedAE), and percentage of eyes within ±0.25, ±0.50, ±1.00, and ±2.00 diopter of the predicted refraction, of each formula were analyzed using manufacturer’s, ULIB, and optimized lens constants. MedAE was compared across various constants used by Wilcoxon signed-rank test and among optimized constants by Friedman’s test. Cochran’s Q test compared the percentage of eyes within ± 0.25, ±0.50, ±1.00, and ± 2.00 diopter of the predicted refraction. A value of P < 0.05 was considered statistically significant. Results: Optimized constant of Haigis had significantly lower MedAE (P < 0.00001) as compared to manufacturers. However, there was no statistically significant difference between ULIB and optimized constants. Postoptimization, there was no statistically significant difference among all formulae. Conclusion: Optimizing lens constants specifically for short eyes gives no added advantage over those optimized for the entire range of axial length.
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Affiliation(s)
- Ankur K Shrivastava
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Swatishree Nayak
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | | | - Mary Anto
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rajaram Kacher
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ajay Kumar
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Kim GH, Whang WJ, Kim HS. Prediction of Effective Lens Position by Reference to the Preoperative Axial Length. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.3.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Intraocular lens power calculation for plus and minus lenses in high myopia using partial coherence interferometry. Int Ophthalmol 2021; 41:1585-1592. [PMID: 33521894 PMCID: PMC8087604 DOI: 10.1007/s10792-020-01684-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 12/19/2020] [Indexed: 11/17/2022]
Abstract
Purpose We assessed the accuracy of lens power calculation in highly myopic patients implanting plus and minus intraocular lenses (IOL). Methods We included 58 consecutive, myopic eyes with an axial length (AL) > 26.0 mm, undergoing phacoemulsification and IOL implantation following biometry using the IOLMaster 500. For lens power calculation, the Haigis formula was used in all cases. For comparison, refraction was back-calculated using the Barrett Universal II (Barrett), Holladay I, Hill-RBF (RBF) and SRK/T formulae. Results The mean axial length was 30.17 ± 2.67 mm. Barrett (80%), Haigis (87%) and RBF (82%) showed comparable numbers of IOLs within 1 diopter (D) of target refraction. Visual acuity (BSCVA) improved (p < 0.001) from 0.60 ± 0.35 to 0.29 ± 0.29 logMAR (> 28-days postsurgery). The median absolute error (MedAE) of Barrett 0.49 D, Haigis 0.38, RBF 0.44 and SRK/T 0.44 did not differ. The MedAE of Haigis was significantly smaller than Holladay (0.75 D; p = 0.01). All median postoperative refractive errors (MedRE) differed significantly with the exception of Haigis to SRK/T (p = 0.6): Barrett − 0.33 D, Haigis 0.25, Holladay 0.63, RBF 0.04 and SRK/T 0.13. Barrett, Haigis, Holladay and RBF showed a tendency for higher MedAEs in their minus compared to plus IOLs, which only reached significance for SRK/T (p = 0.001). Barrett (p < 0.001) and RBF (p = 0.04) showed myopic, SRK/T (p = 002) a hyperopic shift in their minus IOLs. Conclusions In highly myopic patients, the accuracies of Barrett, Haigis and RBF were comparable with a tendency for higher MedAEs in minus IOLs. Barrett and RBF showed myopic, SRK/T a hyperopic shift in their minus IOLs.
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Go JA, Gupta A, Khandelwal SS. Five Pearls for Long Eyes. Ophthalmology 2021. [DOI: 10.17925/opht.2021.15.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kaweri L, Wavikar C, James E, Pandit P, Bhuta N. Review of current status of refractive lens exchange and role of dysfunctional lens index as its new indication. Indian J Ophthalmol 2020; 68:2797-2803. [PMID: 33229654 PMCID: PMC7856935 DOI: 10.4103/ijo.ijo_2259_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Advances in phacodynamics and intraocular lenses (IOLs) has given second life to clear lens extraction (CLE) or refractive lens exchange (RLE) in recent years for the treatment of patients with high degrees of myopia, hyperopia, and astigmatism who are unsuitable for laser surgery. Furthermore, presbyopia treatment with RLE supplemented with multifocal or accommodating IOLs gives the dual benefit of correcting refractive errors with eliminating the need for cataract surgery. RLE should be consistent and effective for a good refractive outcome along with safety during the surgical procedure and in the postoperative period. Therefore, proper patient selection and accurate preoperative protocols for IOL power calculations and selection are important along with an appropriate choice of surgical procedure. Dysfunctional lens index is a new objective tool that helps surgeon to aid in diagnosing, counseling, and educating patients with dysfunctional clear lens. In this article, we give a brief overview about the application of RLE for individuals with presbyopia and refractive errors like myopia, hyperopia, and astigmatism who are not suitable for laser correction.
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Affiliation(s)
- Luci Kaweri
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Chandrashekhar Wavikar
- Department of Cataract and Refractive Surgery, Wavikar Eye Institute, Mumbai, Maharashtra, India
| | - Edwin James
- Assistant Professor, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Payal Pandit
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Namrata Bhuta
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
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Naujokaitis T, Scharf D, Baur I, Khoramnia R, Auffarth GU. Bilateral implantation of +56 and +58 diopter custom-made intraocular lenses in patient with extreme nanophthalmos. Am J Ophthalmol Case Rep 2020; 20:100963. [PMID: 33089013 PMCID: PMC7566091 DOI: 10.1016/j.ajoc.2020.100963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/13/2020] [Accepted: 10/04/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose To present the case of a 60-year-old patient with severe nanophthalmic eyes, who underwent cataract surgery with a bilateral implantation of custom-made high-power intraocular lenses (IOLs). Observations The axial length was 14.94 and 15.05 mm of the right and the left eye, respectively. The preoperative corrected distance visual acuity (CDVA) was +0.46 logMAR (20/63) in the right eye and +0.58 logMAR (20/80) in the left eye with rigid contact lenses of +17.5 D bilaterally. The calculated IOL power for emmetropia with different formulas ranged from +55.28 to +70.09 D. The IOL power selection was based on the average value from four formulas (Haigis, Holladay 1, Holladay 2, SRK/T) with the target refraction of emmetropia. Custom-made +56.0 and + 58.0 D Aspira-aAY IOLs (HumanOptics AG, Erlangen, Germany) were implanted without any complications. The postoperative CDVA was +0.40 logMAR (20/50) and +0.60 logMAR (20/80). The manifest refraction spherical equivalents were +0.625 D and −0.375 D. Conclusions and importance Even in eyes with the axial length of only 15 mm, cataract surgery can be successfully performed after adequate preparation. High-power customized IOLs allow complete correction of hyperopia but caution is required with the results from different IOL power calculation formulas, which can be misleading.
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Affiliation(s)
- Tadas Naujokaitis
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Debora Scharf
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Isabella Baur
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
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Reliability of a New Swept-Source Optical Coherence Tomography Biometer in Healthy Children, Adults, and Cataract Patients. J Ophthalmol 2020; 2020:8946364. [PMID: 32509343 PMCID: PMC7246393 DOI: 10.1155/2020/8946364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/04/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose To comprehensively assess the reliability of a new optical biometer (IOLMaster 700), based on swept-source optical coherence tomography (SS-OCT) and comparison with a standard biometer (IOLMaster 500), in healthy children, adults, and cataract patients. Methods A total of 301 eyes from 301 consecutive subjects were enrolled prospectively. Two experienced operators measured each eye three times consecutively with the IOLMaster 700. The axial length (AL), keratometry (K), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), and white-to-white (WTW) distance were recorded. Intraoperator repeatability and interoperator reproducibility of the IOLMaster 700 were analyzed using the test-retest (TRT), coefficients of variation (CoV), and intraclass correlation coefficients (ICCs). The agreement between the two devices was evaluated using the Bland–Altman method. Results The repeatability and reproducibility of the SS-OCT optical biometer were high for all ocular biometry parameters in all groups, except for the WTW in cataract patients (TRT, 0.27–0.44 mm; ICC, 0.86–0.95). The reproducibility of averaged measurements from three consecutive readings (TRT : AL = 0.02 mm, CCT = 5.41 μm, ACD = 0.03 mm, LT = 0.03 mm, Km = 0.17 D, and WTW = 0.22 mm) was higher than the reproducibility of single measurements (TRT : AL = 0.04 mm, CCT = 7.43 μm, ACD = 0.06 mm, LT = 0.05 mm, Km = 0.26 D, and WTW = 0.35 mm) in the three groups. The consistency in the data between the two biometers was high, with narrow 95% LoAs in the three groups. Conclusion Repeatability and reproducibility of the new SS-OCT optical biometer were excellent and consistent with that of the standard biometer with respect to healthy children, healthy adults, and cataract patients.
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Zhu X, He W, Du Y, Lu Y. Effect of fixation stability during biometry measurements on refractive prediction accuracy in highly myopic eyes. J Cataract Refract Surg 2019; 43:1157-1162. [PMID: 28991611 DOI: 10.1016/j.jcrs.2017.06.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/26/2017] [Accepted: 06/02/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE To assess the effect of preoperative biometry fixation stability on postoperative refractive errors in highly myopic cataractous eyes. SETTING Eye and ENT Hospital of Fudan University, Shanghai, China. DESIGN Prospective cohort study. METHODS Eyes of highly myopic patients and emmetropic controls were included. Routine ophthalmologic examinations and measurement of fixation stability in the 63% and 95% bivariate contour ellipse areas (BCEAs) were conducted preoperatively. The refractive error from prediction was calculated 1 month postoperatively with the SRK/T and Holladay 1 formulas. Univariate and multivariable analyses were performed to identify the factors associated with postoperative refractive errors. RESULTS The refractive errors were more widely distributed in the 45 highly myopic eyes than in the 40 emmetropic control eyes: SRK/T, +0.15 diopter [D] ± 0.80 [SD] and -0.16 ± 0.35 D, respectively; Holladay 1, +0.54 ± 0.79 D and -0.23 ± 0.34 D, respectively. In the highly myopic group, 63% BCEA was correlated with axial length (AL) (P = .021) and posterior subcapsular opacity grade (P = .040). With both formulas, refractive errors and absolute refractive errors were positively correlated with 63% BCEA: SRK/T, P = .010 and P = .001, respectively; Holladay 1, P = .006 and P = .003, respectively. Backward multiple linear regression analysis showed that with both formulas, AL and 63% BCEA were significantly associated with postoperative refractive errors. CONCLUSION Poor preoperative biometry fixation stability correlated with long AL and severe posterior subcapsular opacity contributed to significant deviation of refractive errors after cataract surgery in highly myopic eyes.
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Affiliation(s)
- Xiangjia Zhu
- From the Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University; the Key Laboratory of Myopia, Ministry of Health; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenwen He
- From the Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University; the Key Laboratory of Myopia, Ministry of Health; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yu Du
- From the Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University; the Key Laboratory of Myopia, Ministry of Health; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yi Lu
- From the Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University; the Key Laboratory of Myopia, Ministry of Health; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
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Zhang J, Ning XN, Yan H. Adjustment of IOL power for the second eye based on refractive error of the first-operated eye. Int J Ophthalmol 2019; 12:1348-1350. [PMID: 31456928 DOI: 10.18240/ijo.2019.08.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 06/03/2019] [Indexed: 11/23/2022] Open
Abstract
This study was to estimate refractive status of the second eye of those undergo bilateral cataract surgery based on the first-operated eye, and to evaluate the refractive error (RE) in the second eye after correcting 50% of the first-operated eye's error when it exceeded ±0.50 diopter (D). In this prospective study, 80 patients were scheduled for cataract surgery in the second eye, who underwent cataract surgery in first eye 1-3mo previously. The RE of each eye postoperatively was determined according to SRK/T formula. When the first-eye refractive error (FERE) exceeded ±0.5 D, the intraocular lens (IOL) power of the second eye was adjusted 50% of the FERE. The second-eye refractive error (SERE) was measured 1mo after surgery. The FERE exceeded -0.50 D in 12 eyes (-0.675±0.16 D), and the adjusted SERE was -0.322±0.73 D (P<0.05). The FERE exceeded +0.50 D in 8 eyes (1.533±1.14 D), and the adjusted SERE was 0.168±1.36 D (P<0.05). The unadjusted SERE in 60 cases remained -0.38 to 0.42 D when the FERE within ±0.05 D. This prospective study confirmed that the prediction of the second eye could be improved by correcting 50% of FERE when this error exceeded ±0.50 D.
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Affiliation(s)
- Jie Zhang
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, Shaanxi Province, China
| | - Xiao-Na Ning
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, Shaanxi Province, China
| | - Hong Yan
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, Shaanxi Province, China.,Xi'an No.4 Hospital, Shaanxi Eye Hospital, Affiliated Guangren Hospital School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
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Sudhakar S, Hill DC, King TS, Scott IU, Mishra G, Ernst BB, Pantanelli SM. Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in short eyes. J Cataract Refract Surg 2019; 45:719-724. [DOI: 10.1016/j.jcrs.2018.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 02/08/2023]
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16
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Kohnen T. Steering evolution. J Cataract Refract Surg 2019; 45:709-710. [PMID: 31146929 DOI: 10.1016/j.jcrs.2019.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Rong X, He W, Zhu Q, Qian D, Lu Y, Zhu X. Intraocular lens power calculation in eyes with extreme myopia: Comparison of Barrett Universal II, Haigis, and Olsen formulas. J Cataract Refract Surg 2019; 45:732-737. [PMID: 30876784 DOI: 10.1016/j.jcrs.2018.12.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/28/2018] [Accepted: 12/30/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE To compare the accuracy of the Barrett Universal II, Haigis, and Olsen formulas in calculating intraocular lens (IOL) power in eyes with extreme myopia. SETTING Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China. DESIGN Prospective case series. METHODS Eyes were divided into 3 axial length (AL) groups as follows: 26.0 to 28.0 mm (control), 28.0 to 30.0 mm (extreme myopia 1), and 30.0 mm or more (extreme myopia 2). The mean error (ME) 1 month postoperatively was adjusted to zero by optimizing the lens factor; then, the median absolute errors (MedAEs) were compared between formulas. Factors associated with postoperative refractive errors were analyzed. RESULTS After optimization, the MEs of the Barrett Universal II, Haigis, and Olsen formulas were 0.04 diopter (D) ± 0.48 (SD), 0.04 ± 0.66 D, and 0.04 ± 0.52 D, respectively, and the MedAEs were 0.37 D, 0.46 D, and 0.39 D, respectively (P = .044; Haigis versus Barrett: P = .038). In the extreme myopia 1 group, all 3 formulas produced small MedAEs (P = .662). In the extreme myopia 2 group, the Haigis formula produced a significantly greater MedAE than the Barrett Universal II formula (P = .007; Haigis versus Olsen: P = .055). The accuracy of the Haigis formula in myopic eyes was affected by the AL and keratometry value, whereas the accuracy of the Barrett Universal II and Olsen formulas was affected by the AL only. CONCLUSIONS In eyes with an AL of 28.0 to 30.0 mm, all 3 formulas were accurate. In eyes with AL of 30.0 mm or more, the Barrett Universal II formula was better than the Haigis formula, possibly because there were fewer influencing factors.
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Affiliation(s)
- Xianfang Rong
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenwen He
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qian Zhu
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Dongjin Qian
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
| | - Xiangjia Zhu
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences; and Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
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18
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Kohnen T. Ocular optical aberrations. J Cataract Refract Surg 2018; 44:1167-1168. [DOI: 10.1016/j.jcrs.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kansal V, Schlenker M, Ahmed IIK. Interocular Axial Length and Corneal Power Differences as Predictors of Postoperative Refractive Outcomes after Cataract Surgery. Ophthalmology 2018; 125:972-981. [DOI: 10.1016/j.ophtha.2018.01.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/06/2018] [Accepted: 01/16/2018] [Indexed: 10/18/2022] Open
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20
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Steinwender G, Schwarz L, Böhm M, Slavík-Lenčová A, Hemkeppler E, Shajari M, Kohnen T. Visual results after implantation of a trifocal intraocular lens in high myopes. J Cataract Refract Surg 2018; 44:680-685. [DOI: 10.1016/j.jcrs.2018.04.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/02/2018] [Accepted: 04/12/2018] [Indexed: 11/27/2022]
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21
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Wang Q, Jiang W, Lin T, Zhu Y, Chen C, Lin H, Chen W. Accuracy of intraocular lens power calculation formulas in long eyes: a systematic review and meta-analysis. Clin Exp Ophthalmol 2018; 46:738-749. [PMID: 29498180 DOI: 10.1111/ceo.13184] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/18/2018] [Accepted: 02/25/2018] [Indexed: 11/30/2022]
Abstract
IMPORTANCE Visual outcome after intraocular lens (IOL) implantation in long eyes is considerably affected by IOL power calculation. Various formulas have been designed to achieve an accurate IOL power prediction. However, controversy about the accuracy remains. BACKGROUND To evaluate the accuracy of IOL power calculation formulas in long eyes. DESIGN Meta-analysis. PARTICIPANTS Patients with ocular axial length (AL) over 24.5 mm. METHODS A comprehensive search in PubMed, EMBASE, Cochrane Data Base of Systematic Reviews and the Cochrane Central Register of Controlled Trials were conducted by September, 2017. The weighted mean differences of mean absolute errors (MAE) and the odds ratio of percentage of eyes within ±0.50D of prediction error among formulas were analysed. MAIN OUTCOMES MEASURES Between-group differences of MAE among formulas. RESULTS Eleven observational studies, involving 4047 eyes, were enrolled. Six formulas for IOL power calculation were compared: Barrett Universal II, Haigis, Holladay 2, SRK/T, Hoffer Q and Holladay 1. The MAE of Barrett Universal II was statistically lower than that of Holladay 2 (mean difference, MD = -0.04D, P = 0.0002), SRK/T (MD = -0.05D, P < 0.00001), Hoffer Q (MD = -0.07D, P < 0.00001) and Holladay 1 (MD = -0.07D, P < 0.00001). Barrett Universal II yielded significantly higher percentage of eyes within ±0.50D of the prediction error than the other formulas. The heterogeneity was minimized through dividing eyes into two groups by the AL of 26 mm. CONCLUSIONS AND RELEVANCE This study demonstrates the superiority of Barrett Universal II over Holladay 2, SRK/T, Hoffer Q and Holladay 1 in predicting IOL power in long eyes.
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Affiliation(s)
- Qiwei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wu Jiang
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Tiao Lin
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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22
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Day AC, Cooper D, Burr J, Foster PJ, Friedman DS, Gazzard G, Che-Hamzah J, Aung T, Ramsay CR, Azuara-Blanco A. Clear lens extraction for the management of primary angle closure glaucoma: surgical technique and refractive outcomes in the EAGLE cohort. Br J Ophthalmol 2018; 102:1658-1662. [PMID: 29453222 DOI: 10.1136/bjophthalmol-2017-311447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/04/2018] [Accepted: 01/31/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND To describe the surgical technique and refractive outcomes following clear lens extraction (CLE) in the Effectiveness, in Angle-closure Glaucoma, of Lens Extraction trial. METHODS Review of prospectively collected data from a multicentre, randomised controlled trial comparing CLE and laser peripheral iridotomy. Eligible participants were ≥50 years old and newly diagnosed with (1) primary angle closure (PAC) with intraocular pressure above 30 mm Hg or (2) PAC glaucoma. We report the postoperative corrected distance visual acuity (CDVA) and refractive outcomes at 12 and 36 months postoperatively for those who underwent CLE. RESULTS Of the 419 participants, 208 were randomised to CLE. Mean baseline CDVA was 77.9 (SD 12.4) letters and did not change significantly at 36 months when mean CDVA was 79.9 (SD 10.9) letters. Mean preoperative spherical equivalents were +1.7 (SD 2.3) and +0.08 (SD 0.95) diopters (D) at 36 months. Fifty-nine per cent and 85% eyes were within ±0.5D and ±1.0D of predicted refraction, respectively, at 36 months. CONCLUSIONS Mean CDVA in patients undergoing CLE for angle-closure glaucoma appeared stable over the 3-year study period. Refractive error was significantly reduced with surgery but refractive predictability was suboptimal. TRIAL REGISTRATION NUMBER
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Affiliation(s)
- Alexander C Day
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | - David Cooper
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jennifer Burr
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | | | - Gus Gazzard
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and University College London, London, UK
| | | | - Tin Aung
- Singapore Eye Research Institute, Singapore
| | - Craig R Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Voytsekhivskyy OV. Development and Clinical Accuracy of a New Intraocular Lens Power Formula (VRF) Compared to Other Formulas. Am J Ophthalmol 2018; 185:56-67. [PMID: 29102605 DOI: 10.1016/j.ajo.2017.10.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 10/23/2017] [Accepted: 10/24/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE To develop and compare the accuracy and reproducibility of the VRF intraocular lens (IOL) power calculation formula with well-known methods. DESIGN Development and validation study. METHODS This analysis comprised 823 eyes of 823 patients at Kiev Clinical Ophthalmology Hospital Eye Microsurgery Center, Kiev, Ukraine, operated on by 1 surgeon with 3 different types of hydrophobic lenses: IQ SN60WF (494 eyes) and ReSTOR SN6AD1 (169 eyes) (Alcon Labs, Fort Worth, Texas, USA) and AMO Tecnis MF ZMB00 (160 eyes) (J&J Vision, Santa Ana, California, USA). The full data set was divided into 2 subsets, the first to develop the new formula and the second to evaluate their performance with other most commonly used modern methods of IOL power calculation (Haigis, Hoffer Q, Holladay 1, Holladay 2, SRK/T, and T2). The VRF algorithm is empirical; it uses 4 predictors for estimation of postoperative lens position, including axial length, corneal power (K), preoperative anterior chamber depth (corneal epithelium to lens), and horizontal corneal diameter. The results are also stratified into groups of short (≤22 mm), medium (>22 to <24.5 mm), medium-long (≥24.5 to <26 mm), and long (≥26 mm) axial length. RESULTS The mean error, median absolute error, and mean absolute error were evaluated for all 7 methods with 1 IOL type. The VRF formula had the lowest median (0.305 diopter [D]) absolute error over the entire axial length range, and was comparable with the formulas for T2 (0.321 D) and Holladay 1 (0.326 D). CONCLUSION The new formula was comparable with well-known methods and was better over the entire axial length range.
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Wang Q, Jiang W, Lin T, Wu X, Lin H, Chen W. Meta-analysis of accuracy of intraocular lens power calculation formulas in short eyes. Clin Exp Ophthalmol 2017; 46:356-363. [DOI: 10.1111/ceo.13058] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/24/2017] [Accepted: 08/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Qiwei Wang
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou; People's Republic of China
| | - Wu Jiang
- Department of Colorectal Surgery; Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Guangzhou People's Republic of China
| | - Tiao Lin
- The First Affiliated Hospital; Sun Yat-sen University; Guangzhou People's Republic of China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou; People's Republic of China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou; People's Republic of China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou; People's Republic of China
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Razmjoo H, Atarzadeh H, Kargar N, Behfarnia M, Nasrollahi K, Kamali A. The Comparative Study of Refractive Index Variations between Haigis, Srk/T and Hoffer-Q Formulas Used for Preoperative Biometry Calculation in Patients with the Axial Length >25 mm. Adv Biomed Res 2017; 6:78. [PMID: 28808644 PMCID: PMC5539664 DOI: 10.4103/2277-9175.210657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: To compare refractive index variation between Hoffer-Q, Haigis and SRK/T formulas used for preoperative biometry calculation in patients with axial length >25 mm, undergoing cataract surgery. Materials and Methods: This is a randomized clinical trial study was performed on 54 eyes of 54 patients with ages of 40–70 years old and axial length >25 mm classified into three groups that their IOL POWER were calculated by Haigis, SRK/T and Hoffer-Q formulas before undergoing cataract surgery. Their refractive index variations were calculated from the difference between predicted refractive error formula and actual post-operative refractive error formula. The collected data was entered in SPSS software and was analyzed by ANOVA and Chi-square statistical test. Results: With comparison sphere, astigmatism and spherical equivalent indexes before and after of cataract surgery between Haigis, SRK/T, and Hoffer-Q formulas, statistically significant differences were found between the mean of sphere and SE indexes in patients with use of Haigis and SRK/T formulas that have been more favorable post-operative refraction. Conclusions: Haigis formula and then, with slight difference, SRK/T formula have better and more acceptable post-operative refraction results than Hoffer-Q formula in patients with high axial myopia. Therefore, it is recommended using Haigis and SRK/T formulas for IOL power calculation in patients with high axial myopia undergoing cataract surgery.
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Affiliation(s)
- Hasan Razmjoo
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Hosein Atarzadeh
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Neda Kargar
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Mohammad Behfarnia
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Kobra Nasrollahi
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
| | - Ali Kamali
- Department of Ophthalmology, Isfahan University of Medical sciences, Isfahan, Iran
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Gökce SE, Zeiter JH, Weikert MP, Koch DD, Hill W, Wang L. Intraocular lens power calculations in short eyes using 7 formulas. J Cataract Refract Surg 2017; 43:892-897. [DOI: 10.1016/j.jcrs.2017.07.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/22/2017] [Accepted: 03/29/2017] [Indexed: 12/31/2022]
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27
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Geggel HS. Comparison of formulas and methods for high myopia patients requiring intraocular lens powers less than six diopters. Int Ophthalmol 2017. [DOI: 10.1007/s10792-017-0611-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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28
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Meier PG, Majo F, Othenin-Girard P, Bergin C, Guber I. Refractive outcomes and complications after combined copolymer phakic intraocular lens explantation and phacoemulsification with intraocular lens implantation. J Cataract Refract Surg 2017; 43:748-753. [DOI: 10.1016/j.jcrs.2017.03.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/14/2017] [Accepted: 03/07/2017] [Indexed: 11/26/2022]
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Srinivasan B, Leung HY, Cao H, Liu S, Chen L, Fan AH. Modern Phacoemulsification and Intraocular Lens Implantation (Refractive Lens Exchange) Is Safe and Effective in Treating High Myopia. Asia Pac J Ophthalmol (Phila) 2017; 5:438-444. [PMID: 27898449 DOI: 10.1097/apo.0000000000000241] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Improved efficacy, predictability, and safety of modern phacoemulsification have resulted in cataract surgery being considered as a refractive procedure. Refractive lens exchange by definition is a surgery aimed at replacing the cataractous or clear crystalline lens with an intraocular lens (IOL) in cases of high ametropia. The excellent intraocular optics of this procedure provide a better visual outcome as compared with laser refractive surgery in high myopia. With advances in technology and IOL formulas, the predictability of refractive outcome after cataract surgery in high myopes has improved. The option of addressing presbyopia using multifocal/accommodating IOLs or monovision results in patients achieving reasonable spectacle independence. The most important concern with respect to phacoemulsification in high myopia is the risk of pseudophakic retinal detachment. High myopia is an independent risk factor for retinal detachment, and recent publications have reported a much lesser risk of retinal detachment specifically attributable to phacoemulsification in high myopes, especially if a thorough posterior segment evaluation is done and patients are followed up until development of complete posterior vitreous detachment. Refractive lens exchange is an effective and safe option to correct high myopia and can significantly improve quality of life in select patients.
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Affiliation(s)
- Bhaskar Srinivasan
- From the *C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, China; †Sankara Nethralaya, Chennai, India; and ‡Dennis Lam & Partners Eye Center, Hong Kong
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Güler E, Kulak AE, Totan Y, Yuvarlak A, Hepşen İF. Comparison of a new optical biometry with an optical low-coherence reflectometry for ocular biometry. Cont Lens Anterior Eye 2016; 39:336-41. [DOI: 10.1016/j.clae.2016.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 04/26/2016] [Accepted: 06/07/2016] [Indexed: 11/25/2022]
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Fixation Stability and Refractive Error After Cataract Surgery in Highly Myopic Eyes. Am J Ophthalmol 2016; 169:89-94. [PMID: 27325397 DOI: 10.1016/j.ajo.2016.06.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 06/05/2016] [Accepted: 06/11/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE To analyze the refractive error in highly myopic eyes after cataract surgery and investigate the possible impact of fixation stability on it. DESIGN Secondary data analysis from a previous prospective study. METHODS Clinical data of 98 eyes of 98 consecutive patients with high myopia and 42 eyes of 42 controls, which underwent cataract surgery, were analyzed. Refractive error was calculated 1 month after surgery based on both Sanders-Retzlaff-Kraff theoretic (SRK/T) and Holladay 1 formulas. Fixation stability was evaluated using the Macular Integrity Assessment microperimeter system, which assessed the fixation pattern in terms of 63% and 95% of the bivariate contour ellipse area (BCEA). Multiple linear regression analysis was performed to identify independent predictors of postoperative refractive error. RESULTS The highly myopic cataract group had greater hyperopic refractive errors (P < .001 for both formulas) and larger 63% and 95% BCEA values (P = .033 and P = .034) than the control group. In the highly myopic group, the factors 63% or 95% BCEA were positively correlated with the postoperative refractive error (SRK/T formula, r = 0.383, P < .001 and r = 0.320, P = .002, respectively). Multiple linear regression analysis showed that with the SRK/T formula, postoperative refractive error in highly myopic eyes was significantly correlated with axial length (β = 0.491, P < .001), 63% BCEA (β = 0.181, P = .045), and corneal curvature (β = -0.190, P = .024). The refractive error was no longer associated with corneal curvature after using the Holladay 1 formula. CONCLUSIONS Highly myopic eyes usually had hyperopic refractive errors after cataract surgery. Fixation stability might serve as an important determinant of postoperative refractive errors in this population.
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Çağlar Ç, Kocamış Sİ, Demir E, Durmuş M. Comparison of the measurements of a novel optical biometry: Nidek AL-Scan with Sirius and a ultrasound biometry. Int Ophthalmol 2016; 37:491-498. [PMID: 27392914 DOI: 10.1007/s10792-016-0284-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 07/02/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Çağatay Çağlar
- Department of Ophthalmology, Faculty of Medicine, Hitit University, Çorum, Turkey.
| | | | - Emre Demir
- Department of Biostatistics, Faculty of Medicine, Hitit University, Çorum, Turkey
| | - Mustafa Durmuş
- Department of Ophthalmology, Faculty of Medicine, Hitit University, Çorum, Turkey
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Karabela Y, Eliacik M, Kaya F. Performance of the SRK/T formula using A-Scan ultrasound biometry after phacoemulsification in eyes with short and long axial lengths. BMC Ophthalmol 2016; 16:96. [PMID: 27391470 PMCID: PMC4938914 DOI: 10.1186/s12886-016-0271-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 06/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The SRK/T formula is one of the third generation IOL calculation formulas. The purpose of this study was to evaluate the performance of the SRK/T formula in predicting a target refraction ±1.0D in short and long eyes using ultrasound biometry after phacoemulsification. METHODS The present study was a retrospective analysis, which included 38 eyes with an AL < 22.0 mm (short AL), and 62 eyes ≥24.6 mm (long AL) that underwent uncomplicated phacoemulsification. Preoperative AL was measured by ultrasound biometry and SRK/T formula was used for IOL calculation. Three different IOLs were implanted in the capsular bag. The prediction error was defined as the difference between the achieved postoperative refraction, and attempted predicted target refraction. Statistical analysis was performed with SPSS V21. RESULTS In short ALs, the mean age was 65.13 ± 9.49 year, the mean AL was 21.55 ± 0.45 mm, the mean K1 and K2 were 45.76 ± 1.77D and 46.09 ± 1.61D, the mean IOL power was 23.96 ± 1.92D, the mean attempted (predicted) value was 0.07 ± 0.26D, the mean achieved value was 0.07 ± 0.63 D, the mean PE was 0.01 ± 0.60D, and the MAE was 0.51 ± 0.31D. A significant positive relationship with AL and K1, K2, IOL power and a strong negative relationship with PE and achieved postoperative was found. In long ALs, the mean age was 64.05 ± 7.31 year, the mean AL was 25.77 ± 1.64 mm, the mean K1 and K2 were 42.20 ± 1.57D and 42.17 ± 1.68D, the mean IOL power was 15.79 ± 5.17D, the mean attempted value was -0.434 ± 0.315D, the mean achieved value was -0.42 ± 0.96D, the mean PE was -0.004 ± 0.93D, the MAE was 0.68 ± 0.62D. A significant positive relationship with AL and K1, K2 and a significant positive relationship with PE and achieved value, otherwise a negative relationship with AL and IOL power was found. There was a little tendency towards hyperopic for short ALs and myopic for long ALs. The majority of eyes (94.74 %) for short ALs and (70.97 %) for long ALs were within ±1 D of the predicted refractive error. No significant relationship with PE and IOL types, AL, K1, K2, IOL power, and attempted value, besides with MAE and AL, K1, K2, age, attempted, achieved value were found in both groups. CONCLUSION The SRK/T formula performs well and shows good predictability in eyes with short and long axial lengths.
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Affiliation(s)
- Yunus Karabela
- Department of Ophthalmology, Istanbul Medipol University, Esenler Hospital, Birlik Mah., Bahceler Cad., Number 5, Esenler, Istanbul, 34230, Turkey.
| | - Mustafa Eliacik
- Department of Ophthalmology, School of Medicine, Istanbul Medipol University, Kadıkoy Medipol Hospital, Lambaci Sokak Number 1, Kosuyolu, Kadikoy, Istanbul, 34718, Turkey
| | - Faruk Kaya
- Department of Ophthalmology, Istanbul Medipol University, Esenler Hospital, Birlik Mah., Bahceler Cad., Number 5, Esenler, Istanbul, 34230, Turkey
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Abstract
PURPOSE OF REVIEW Cataract surgery in high myopes is challenging. Using third-generation intraocular lens (IOL) formulas, without adjustments, hyperopic refractive outcomes are common. We discuss these issues, focusing on the various lens formulas and transformations that have improved postoperative accuracy. RECENT FINDINGS Axial length measurement error has been largely overcome by the use of optical interferometry. Despite this, consistent hyperopic errors are still reported. We reviewed the postoperative refraction results compared with the predicted refractions using: standard formulas (Holladay 1, SRK/T, Hoffer Q, and Haigis) with manufacturers' optical lens constants, the User Group for Laser Interference Biometry (ULIB) constants, manufacturers' constants with axial length adjustment method, and fourth-generation IOL formulas (Barrett Universal II, Holladay 2, and Olsen). SUMMARY Improved predictive results is obtained with the Barrett Universal II (software constants), Haigis (ULIB), SRK/T, Holladay 2 (software constants), and Olsen (software constants) formulas in eyes with axial lengths greater than 26.0 mm and IOL powers greater than 6.0 D. In eyes with axial lengths greater than 26.0 mm and IOL less than 6.0 D, the Barrett Universal II formula (software constants) and the Haigis (axial length adjusted) and Holladay 1 formulas (axial length-adjusted) should be used.
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Accuracy of Intraocular Lens Power Calculation Formulas for Highly Myopic Eyes. J Ophthalmol 2016; 2016:1917268. [PMID: 27119018 PMCID: PMC4828549 DOI: 10.1155/2016/1917268] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/10/2016] [Accepted: 03/13/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose. To evaluate and compare the accuracy of different intraocular lens (IOL) power calculation formulas for eyes with an axial length (AL) greater than 26.00 mm. Methods. This study reviewed 407 eyes of 219 patients with AL longer than 26.0 mm. The refractive prediction errors of IOL power calculation formulas (SRK/T, Haigis, Holladay, Hoffer Q, and Barrett Universal II) using User Group for Laser Interference Biometry (ULIB) constants were evaluated and compared. Results. One hundred seventy-one eyes were enrolled. The Barrett Universal II formula had the lowest mean absolute error (MAE) and SRK/T and Haigis had similar MAE, and the statistical highest MAE were seen with the Holladay and Hoffer Q formulas. The interquartile range of the Barrett Universal II formula was also the lowest among all the formulas. The Barrett Universal II formulas yielded the highest percentage of eyes within ±1.0 D and ±0.5 D of the target refraction in this study (97.24% and 79.56%, resp.). Conclusions. Barrett Universal II formula produced the lowest predictive error and the least variable predictive error compared with the SRK/T, Haigis, Holladay, and Hoffer Q formulas. For high myopic eyes, the Barrett Universal II formula may be a more suitable choice.
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Montes de Oca I, Gökce SE, Hallahan K, Wang L, Koch DD. IOL Calculations in Short, Long, and Postrefractive Eyes. Int Ophthalmol Clin 2016; 56:49-70. [PMID: 27257722 DOI: 10.1097/iio.0000000000000119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Kaya F, Kocak I, Aydin A, Baybora H, Karabela Y. Comparison of different formulas for intraocular lens power calculation using a new optical biometer. J Fr Ophtalmol 2015. [DOI: 10.1016/j.jfo.2015.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gorodezky L, Mazinani BA, Plange N, Walter P, Wenzel M, Roessler G. Influence of the prediction error of the first eye undergoing cataract surgery on the refractive outcome of the fellow eye. Clin Ophthalmol 2014; 8:2177-81. [PMID: 25382967 PMCID: PMC4222621 DOI: 10.2147/opth.s69255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction In addition to measurement errors, individual anatomical conditions could be made responsible for unexpected prediction errors in the determination of the correct intraocular lens power for cataract surgery. Obviously, such anatomical conditions might be relevant for both eyes. The purpose of this study was to evaluate whether the postoperative refractive error of the first eye has to be taken in account for the biometry of the second. Methods In this retrospective study, we included 670 eyes of 335 patients who underwent phacoemulsification and implantation of a foldable intraocular lens in both eyes. According to the SRK/T formula, the postoperative refractive error of each eye was determined and compared with its fellow eye. Results Of 670 eyes, 622 showed a postoperative refractive error within ±1.0 D (93%), whereas the prediction error was 0.5 D or less in 491 eyes (73%). The postoperative difference between both eyes was within 0.5 D in 71% and within 1.0 D in 93% of the eyes. Comparing the prediction error of an eye and its fellow eye, the error of the fellow eye was about half the value of the other. Conclusion Our results imply that substitution of half of the prediction error of the first eye into the calculation of the second eye may be useful to reduce the prediction error in the second eye. However, prospective studies should be initiated to demonstrate an improved accuracy for the second eye’s intraocular lens power calculation by partial adjustment.
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Affiliation(s)
- Ludmilla Gorodezky
- Petrisberg Eye Clinic, Trier, Germany ; Department of Ophthalmology, RWTH Technical University of Aachen, Aachen, Germany
| | - Babac Ae Mazinani
- Department of Ophthalmology, RWTH Technical University of Aachen, Aachen, Germany
| | - Niklas Plange
- Department of Ophthalmology, RWTH Technical University of Aachen, Aachen, Germany
| | - Peter Walter
- Department of Ophthalmology, RWTH Technical University of Aachen, Aachen, Germany
| | | | - Gernot Roessler
- Department of Ophthalmology, RWTH Technical University of Aachen, Aachen, Germany
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Alio JL, Grzybowski A, El Aswad A, Romaniuk D. Refractive lens exchange. Surv Ophthalmol 2014; 59:579-98. [DOI: 10.1016/j.survophthal.2014.04.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 04/16/2014] [Accepted: 04/22/2014] [Indexed: 10/25/2022]
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Interchangeability between Pentacam and IOLMaster in phakic intraocular lens calculation. Eur J Ophthalmol 2014; 25:202-7. [PMID: 25363849 DOI: 10.5301/ejo.5000524] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the agreement and interchangeability between IOLMaster and Pentacam in phakic intraocular lens (IOL) calculations. METHODS This was a prospective study involving measurement of the anterior segment parameters anterior chamber depth (ACD), white to white (WTW) line, and average anterior corneal curvature (K-reading) on 108 healthy eyes of 56 consecutive patients. Interdevice agreement and interchangeability in phakic IOL calculations was evaluated. RESULTS Pentacam measured significantly longer ACD measurements (3.54 ± 0.35 mm) than the IOLMaster (3.40 ± 0.37 mm) (p<0.0001); on the other hand, it measured significantly shorter WTW line measurements (11.61 ± 0.44 mm) than the IOLMaster (11.66 ± 0.42 mm) (p = 0.016). No difference was found regarding the average K-readings. For biometry and phakic IOL power calculation, there was no clinically significant difference between the devices, but for phakic IOL diameter calculation the difference was clinically significant. CONCLUSIONS There is a good agreement in ACD and K-readings between Pentacam and IOLMaster, making them interchangeable in biometry and phakic IOL power calculation, but they are not interchangeable regarding WTW line measurement; the difference will affect the phakic IOL diameter, which would affect lens safety.
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Srivannaboon S, Chirapapaisan C, Chonpimai P, Koodkaew S. Comparison of ocular biometry and intraocular lens power using a new biometer and a standard biometer. J Cataract Refract Surg 2014; 40:709-15. [PMID: 24656166 DOI: 10.1016/j.jcrs.2013.09.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 09/30/2013] [Accepted: 09/30/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the repeatability and reproducibility of ocular biometry and intraocular lens (IOL) power obtained with a new optical biometer (AL-Scan) and a standard optical biometer (IOLMaster 500). SETTING Siriraj Hospital, Mahidol University, Bangkok, Thailand. DESIGN Prospective comparative study. METHODS Two independent operators measured eyes with cataract using both biometers. The keratometry values, axial length, anterior chamber depth, white-to-white (WTW) corneal diameter, and IOL power calculated using the Holladay 1 formula obtained with each device were recorded. Intraoperator repeatability and interoperator reproducibility of both devices were analyzed using the intraclass correlation coefficient (ICC). The agreement in ocular biometry and IOL power between the 2 devices was evaluated by the Bland-Altman method. RESULTS The study recruited 137 eyes of 81 patients. The repeatability and reproducibility of both devices were high for all ocular biometry measurements (ICC, 0.87-1.00). Except for the WTW corneal diameter (ICC, 0.44), the agreement between the biometers was also high (ICC, 0.98-0.99). The IOL powers calculated by the Holladay 1 formula were similar between the 2 biometers. CONCLUSION The new optical biometer provided excellent repeatability and reproducibility for all ocular biometry. Agreement with the standard optical biometer was good except for the WTW corneal diameter.
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Affiliation(s)
- Sabong Srivannaboon
- From the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Pratuangsri Chonpimai
- From the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sunisa Koodkaew
- From the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Huerva V. Piggyback multifocal IOLs for a hyperopic–presbyopic surprise after cataract surgery in high myopic patients. Cont Lens Anterior Eye 2014; 37:57-9. [DOI: 10.1016/j.clae.2013.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 07/05/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022]
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Kim BH, Wee WR, Kim MK. Analysis of Factors that Influence on Accuracy of Intraocular Lens Power Calculation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.2.173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Bo Hyuck Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Won Ryang Wee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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Hua X, Yuan XY, Song H, Tang X. Long-term results of clear lens extraction combined with piggyback intraocular lens implantation to correct high hyperopia. Int J Ophthalmol 2013; 6:650-5. [PMID: 24195042 DOI: 10.3980/j.issn.2222-3959.2013.05.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 09/13/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To assess the refractive outcome of clear lensectomy combined with piggyback intraocular lens implantation in highly hyperopic patients. METHODS This case review included 19 eyes of 10 patients with high hyperopia and axial length less than 21mm. Intraocular lens power was calculated for emmetropia using the Holladay II formula in 17 eyes, and SRK/T formula in 2 eyes following clear lens extraction and piggyback intraocular lens implantation. Patients were examined periodically over 24 months for visual acuity and spherical equivalent (SE). RESULTS The mean postoperative SE at 24 months was 0.20±1.39D (range, -3.00 to 2.50D), better than preoperative 9.81±2.62D (range, +6.00 to +14.50D) (P<0.001). Five eyes had SE within ±0.5D of emmetropia and 11 eyes within ±1.00D at postoperative 24 months. The mean postoperative uncorrected visual acuity (UCVA) at 24 months was 0.60±0.36, significantly improved compared to preoperative 1.39±0.33 (P<0.001). The mean best-corrected visual acuity (BCVA) at 24 months was 0.49±0.35, not statistically different compared to preoperative 0.38±0.30 (P=0.34). Twelve eyes maintained and 1 gained 1 or more Snellen line of BCVA, 4 eyes lost 1 line, and 2 eyes lost 2 lines at 24 postoperative months. Twelve eyes best-corrected near visual acuity (BCNVA) achieved J1 at postoperative 24 months compared to preoperative 7 eyes and the other 7 eyes better than J3. CONCLUSION Clear lens extraction combined piggyback intraocular lens implantation appears to be an effective procedure to correct high hyperopia but mild overcorrection and intralenticular opacification may require secondary procedure.
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Affiliation(s)
- Xia Hua
- Tianjin Medical University, No.22 Qixiangtai Rd, Tianjin 300070, China ; Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, No.4 Gansu Rd, Tianjin 300020, China ; Clinic Barraquer of Ophthalmology, C/Laforja 88, Barcelona 08021, Spain
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Comparison of intraocular lens power calculation methods after myopic laser refractive surgery without previous refractive surgery data. J Cataract Refract Surg 2013; 39:1327-35. [DOI: 10.1016/j.jcrs.2013.03.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 02/20/2013] [Accepted: 03/08/2013] [Indexed: 11/17/2022]
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Karunaratne N. Comparison of the Pentacam equivalent keratometry reading and IOL Master keratometry measurement in intraocular lens power calculations. Clin Exp Ophthalmol 2013; 41:825-34. [PMID: 23601493 DOI: 10.1111/ceo.12124] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 03/14/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND To compare the accuracy of the Pentacam Holladay equivalent keratometry readings with the IOL Master 500 keratometry in calculating intraocular lens power. DESIGN Non-randomized, prospective clinical study conducted in private practice. PARTICIPANTS Forty-five consecutive normal patients undergoing cataract surgery. METHODS Forty-five consecutive patients had Pentacam equivalent keratometry readings at the 2-, 3 and 4.5-mm corneal zone and IOL Master keratometry measurements prior to cataract surgery. For each Pentacam equivalent keratometry reading zone and IOL Master measurement the difference between the observed and expected refractive error was calculated using the Holladay 2 and Sanders, Retzlaff and Kraff theoretic (SRKT) formulas. MAIN OUTCOME MEASURE Mean keratometric value and mean absolute refractive error. RESULTS There was a statistically significantly difference between the mean keratometric values of the IOL Master, Pentacam equivalent keratometry reading 2-, 3- and 4.5-mm measurements (P < 0.0001, analysis of variance). There was no statistically significant difference between the mean absolute refraction error for the IOL Master and equivalent keratometry readings 2 mm, 3 mm and 4.5 mm zones for either the Holladay 2 formula (P = 0.14) or SRKT formula (P = 0.47). The lowest mean absolute refraction error for Holladay 2 equivalent keratometry reading was the 4.5 mm zone (mean 0.25 D ± 0.17 D). The lowest mean absolute refraction error for SRKT equivalent keratometry reading was the 4.5 mm zone (mean 0.25 D ± 0.19 D). Comparing the absolute refraction error of IOL Master and Pentacam equivalent keratometry reading, best agreement was with Holladay 2 and equivalent keratometry reading 4.5 mm, with mean of the difference of 0.02 D and 95% limits of agreement of -0.35 and 0.39 D. CONCLUSIONS The IOL Master keratometry and Pentacam equivalent keratometry reading were not equivalent when used only for corneal power measurements. However, the keratometry measurements of the IOL Master and Pentacam equivalent keratometry reading 4.5 mm may be similarly effective when used in intraocular lens power calculation formulas, following constant optimization.
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Wang JK, Chang SW. Optical biometry intraocular lens power calculation using different formulas in patients with different axial lengths. Int J Ophthalmol 2013; 6:150-4. [PMID: 23638414 DOI: 10.3980/j.issn.2222-3959.2013.02.08] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Accepted: 03/20/2013] [Indexed: 12/11/2022] Open
Abstract
AIM : To investigate the predictability of intraocular lens (IOL) power calculation using the IOLMaster and different IOL power calculation formulas in eyes with various axial length (AL). METHODS : Patients were included who underwent uneventful phacoemulsification with IOL implantation in the Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan, China from February 2007 to January 2009. Preoperative AL and keratometric values (Ks) were measured by IOLMaster optical biometry. Patients were divided into 3 groups based on AL less than 22mm (Group 1), 22-26mm (Group 2), and more than 26mm (Group 3). The power of the implanted IOL was used to calculate the predicted postoperative spherical equivalence (SE) by various formulas: the Haigis, Hoffer Q, Holladay 1, and SRK/T. The predictive accuracy of each formula was analyzed by comparing the difference between the actual and predicted postoperative SE (MedAE, median absolute error). All the patients had follow-up periods exceeding 3 months. RESULTS : Totally, there were 200 eyes (33 eyes in Group 1, 92 eyes in Group 2, 75 eyes in Group 3). In all patients, the Haigis had the significantly lower MedAE generated by the other formulas (P<0.05). In Group 1 to 3, the MedAE calculated by the Haigis was either significantly lower or comparable to those calculated by the other formulas. CONCLUSION : Compared with other formulas using IOLMaster biometric data, the Haigis formula yields superior refractive results in eyes with various AL.
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Affiliation(s)
- Jia-Kang Wang
- Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan, China ; Oriental Institute of Technology, Taipei, Taiwan, China ; Department of Medicine, National Yang Ming University, Taipei, Taiwan, China
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A study to evaluate whether CTR increases refractive unpredictability between predicted and actual IOL position. Med J Armed Forces India 2012; 70:36-8. [PMID: 24623945 DOI: 10.1016/j.mjafi.2012.08.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Accepted: 08/12/2012] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The surgical management of cataract associated with extensive zonular loss presents a challenge for ophthalmic surgeon. Capsular Tension Ring (CTR) is commonly being used to stabilize the capsular bag in patients with zonular dialysis. CTR helps to avoid capsular collapse and vitreous presentation in AC during surgery and maintains the capsular bag, allowing the circular contour of the capsular bag, allowing intra ocular lens to be easily placed in the bag. The aim of the study was to know if there is any shift of IOL following use of CTR ring. METHOD We did a Ultrabiomicroscopy (UBM) examination to find out shift in PCIOL in cases in which CTR ring and compared it with cases without CTR ring. RESULT It was found out through UBM in this study that there is actually a posterior shift of PCIOL after use of CTR ring leading to hypermetropic correction needed after surgery. CONCLUSION It is suggested that posterior shift of IOL following use of CTR should be kept in mind and the IOL implanted should be of + 1.0 to 2.0 D more than that calculated preoperatively.
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Whang WJ, Jung BJ, Oh TH, Byun YS, Joo CK. Comparison of postoperative refractive outcomes: IOLMaster® versus immersion ultrasound. Ophthalmic Surg Lasers Imaging Retina 2012; 43:496-9. [PMID: 22869383 DOI: 10.3928/15428877-20120726-03] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Accepted: 01/06/2012] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare the postoperative refractive outcomes between IOLMaster biometry (Carl Zeiss Meditec, Inc., Dublin, CA) and immersion ultrasound biometry for axial length measurements. PATIENTS AND METHODS Refractive outcomes in 354 eyes were compared using the IOLMaster and the immersion ultrasound biometry. Predicted refraction was determined using manual keratometry and the SRK-T formula with personalized A-constant. RESULTS The axial lengths measured using the IOLMaster and immersion ultrasound were 24.49 ± 2.11 and 24.46 ± 2.11 mm, respectively, and the difference was significant (P < .05). The mean errors were 0.000 ± 0.578 D with the IOLMaster, and 0.000 ± 0.599 D with the immersion ultrasound, but the difference was not significant. The mean absolute error was smaller with the IOLMaster than with immersion ultrasound (0.463 ± 0.341 vs 0.479 ± 0.359 D), but the difference was not significant. CONCLUSION IOLMaster biometry yields highly accurate results in cataract surgery. However, if the IOLMaster is unavailable, immersion ultrasound biometry with personalized intraocular lens constants is an acceptable alternative.
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Affiliation(s)
- Woong-Joo Whang
- The Catholic Institute for Visual Science, The Catholic University of Korea, Seoul, Korea
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Day AC, Foster PJ, Stevens JD. Accuracy of intraocular lens power calculations in eyes with axial length <22.00 mm. Clin Exp Ophthalmol 2012; 40:855-62. [PMID: 22594574 DOI: 10.1111/j.1442-9071.2012.02810.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND To assess the accuracy of Haigis, Holladay 1, Hoffer Q and SRK/T formulae in eyes with axial length of <22.00 mm. DESIGN Retrospective comparative analysis. PARTICIPANTS 163 eyes of 97 patients undergoing phacoemulsification and intraocular lens (IOL) implantation. METHODS Ocular biometry was performed using IOLMaster laser interferometry. Predicted refractive outcomes before and after lens constant adjustment were compared to actual refractive outcomes. MAIN OUTCOME MEASURES Mean prediction (ME) and mean absolute errors (MAE) with standard deviations (±SD). RESULTS Mean preoperative spherical equivalent was +5.44D ± 1.97D. Mean axial length was 21.20 mm ± 0.60 mm. Using standard IOL constants the MAE for Hoffer Q (0.62D, ±0.52D) and Holladay 1 (0.66D ± 0.52D) were significantly lower than SRK/T (MAE 0.91D ± 0.64D; P = <0.0005 and P = 0.001 respectively), but not Haigis (MAE 0.82D ± 0.83D, P = 0.071 and 0.22 respectively). MAEs for all formulae were significantly reduced by IOL constant adjustment (all P = <0.001). Following this there was no statistically significant difference in MAEs between formulae (range 0.50-0.57D, P = 0.57). Increasing MAE was significantly associated with reducing axial length and increasing IOL power for all formulae. For bilateral cases, prediction errors between eyes were significantly correlated across all formulae (all P = <0.0001) and explained 32-42% of the variance in prediction error between eyes. CONCLUSIONS Prediction of postoperative refraction in patients with short axial lengths is challenging and at the limit of current, popular IOL formulae. There is now a clear need for prospective studies to assess latest generation IOL formulae such as Holladay 2 or Olsen in small eyes.
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